TY - JOUR
T1 - Triggering for submaximal exercise level in gastric exercise tonometry
T2 - Serial lactate, heart rate, or respiratory quotient?
AU - Otte, Johannes A.
AU - Oostveen, Ellie
AU - Mensink, Peter B.F.
AU - Geelkerken, Robert H.
AU - Kolkman, Jeroen J.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - Gastric exercise tonometry is a functional diagnostic test in chronic gastrointestinal ischemia. As maximal exercise can cause false-positive tests, exercise buildup should be controlled to remain submaximal. We evaluated three parameters for monitoring and adjusting exercise levels (heart rate [HR], respiratory quotient [RQ], and serial lactate measurements) in 178 tests in both healthy volunteers and patients suspected of gastrointestinal ischemia. Exercise levels above submaximal occurred in 20% of HR-, 2% of RQ-, and 5% of lactate-monitored tests (P<0.05 for HR vs. RQ and lactate). Low levels were seen in 5% of HR-, 10% of RQ-, and 41% of lactate-monitored tests (P<0.01 for lactate vs. HR and RQ). High levels resulted in 43% false-positive tonometry results compared to 19% of all tests (P<0.001); low levels did not result in more false negatives (5% vs. 6%). Although RQ monitoring yielded the greatest proportion of optimal exercise tests, serial lactate monitoring is our method of choice, combining optimal diagnostic accuracy, low cost, and simplicity.
AB - Gastric exercise tonometry is a functional diagnostic test in chronic gastrointestinal ischemia. As maximal exercise can cause false-positive tests, exercise buildup should be controlled to remain submaximal. We evaluated three parameters for monitoring and adjusting exercise levels (heart rate [HR], respiratory quotient [RQ], and serial lactate measurements) in 178 tests in both healthy volunteers and patients suspected of gastrointestinal ischemia. Exercise levels above submaximal occurred in 20% of HR-, 2% of RQ-, and 5% of lactate-monitored tests (P<0.05 for HR vs. RQ and lactate). Low levels were seen in 5% of HR-, 10% of RQ-, and 41% of lactate-monitored tests (P<0.01 for lactate vs. HR and RQ). High levels resulted in 43% false-positive tonometry results compared to 19% of all tests (P<0.001); low levels did not result in more false negatives (5% vs. 6%). Although RQ monitoring yielded the greatest proportion of optimal exercise tests, serial lactate monitoring is our method of choice, combining optimal diagnostic accuracy, low cost, and simplicity.
KW - Chronic gastrointestinal ischemia
KW - Diagnosis
KW - Exercise level
KW - Exercise test
KW - Gastric exercise tonometry
KW - Tonometry
UR - http://www.scopus.com/inward/record.url?scp=34347378263&partnerID=8YFLogxK
U2 - 10.1007/s10620-006-9685-0
DO - 10.1007/s10620-006-9685-0
M3 - Article
C2 - 17385029
AN - SCOPUS:34347378263
SN - 0163-2116
VL - 52
SP - 1771
EP - 1775
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 8
ER -